Pharmac funds new treatment for rheumatoid arthritis to support people impacted by tocilizumab stock shortage

Pharmac has funded upadacitinib tablets as an alternative treatment for New Zealanders with severe rheumatoid arthritis, who are impacted by the tocilizumab stock shortage.

“In New Zealand, about 400 people currently use Pharmac-funded tocilizumab for a number of conditions such as rheumatoid and juvenile idiopathic arthritis,” explains Pharmac’s director of operations Lisa Williams.  

“The time between Roche NZ, the supplier of tocilizumab, telling us that there would be an outage and the projected end of supplies was only a matter of weeks. We had to act quickly to find an alternative treatment. The reality is that between this October and January 2022 there won’t be enough tocilizumab to continue treating all who currently use it.

“To preserve remaining tocilizumab stock for priority patients, Pharmac will be funding a new JAK inhibitor[1] called upadacitinib, for use by people with rheumatoid arthritis, from 1 October 2021.   

“Upadacitinib is an oral tablet, unlike tocilizumab, meaning patients will not have to go into hospital for monthly treatment. Securing an alternative treatment option means that demand for tocilizumab will be significantly reduced, which will help ensure that the remaining stock should be enough to treat priority patients until more is due to arrive.”

Upadacitinib is Medsafe approved for use in rheumatoid arthritis and has had a positive funding recommendation from Pharmac’s Pharmacology and Therapeutics Advisory Committee (PTAC) for use in rheumatoid arthritis. People who would like to remain using upadacitinib once supply of tocilizumab resumes, will be able to do so.

AbbVie, the supplier of upadacitinib, has stock immediately available in the country and has indicated they will make product available on direct supply in advance of the planned 1 October funding date.

“Due to the emergency situation that we are responding to, funding upadacitinib for rheumatoid arthritis has not been prioritised against Pharmac’s other options for investment and we have not publicly consulted on funding it (as would be our normal process prior to funding a new medicine). We have, however, consulted with our Rheumatology Subcommittee of PTAC and the Rheumatology Association of New Zealand.

“This has been an unusual situation and we haven’t been able to follow our usual practices,” says Lisa. “We have applied common sense to the situation, and I am proud we have been able to ensure that New Zealander’s who need treatment will be able to access it.”

[1] Janus kinase inhibitors (JAK inhibitors) work by modifying the immune system.